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颅眶沟通性蝶骨嵴脑膜瘤的手术治疗：近全切除与视交叉固定术。

Surgery for clinoidal meningiomas with cavernous sinus extension: Near-total excision and chiasmopexy.

机构信息

Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland.

Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland.

出版信息

Acta Neurochir (Wien). 2022 Sep;164(9):2511-2515. doi: 10.1007/s00701-022-05281-z. Epub 2022 Jun 27.

DOI:10.1007/s00701-022-05281-z
PMID:35761109
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9427927/
Abstract

BACKGROUND

The main factors limiting the extent of resection for clinoidal meningiomas are cavernous sinus extension and vessel adventitia involvement. The proximity to the optic apparatus and the risk of radiation-induced optic neuropathy often prevents many surgeons from proposing adjuvant radiosurgery.

METHOD

We describe a simple technical solution that is to place a fat graft between the optic apparatus and the residual tumor to maintain the distance gained at surgery and facilitates the identification of anatomic structures.

CONCLUSION

This technique allows to deliver optimal therapeutic doses to the residue reduces the dose received by the optic nerve below 8 Gy.

摘要

背景

限制岩骨斜坡脑膜瘤切除范围的主要因素是海绵窦延伸和血管外膜受累。视神经的临近和放射性诱导的视神经病变的风险常常使许多外科医生无法提出辅助放射外科手术。

方法

我们描述了一种简单的技术解决方案，即在视神经和残余肿瘤之间放置脂肪移植物，以保持手术中获得的距离，并有助于识别解剖结构。

结论

该技术允许将最佳治疗剂量传递到残余肿瘤，将视神经接受的剂量降低到 8Gy 以下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5735/9427927/cb2aa82e047e/701_2022_5281_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5735/9427927/7292e0011c89/701_2022_5281_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5735/9427927/4e01a903d0b1/701_2022_5281_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5735/9427927/3deb6aac2152/701_2022_5281_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5735/9427927/cb2aa82e047e/701_2022_5281_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5735/9427927/7292e0011c89/701_2022_5281_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5735/9427927/4e01a903d0b1/701_2022_5281_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5735/9427927/3deb6aac2152/701_2022_5281_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5735/9427927/cb2aa82e047e/701_2022_5281_Fig4_HTML.jpg

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Radiat Oncol. 2019 Nov 12;14(1):201. doi: 10.1186/s13014-019-1397-7.
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Surgery for Clinoidal Meningiomas: Case Series and Meta-Analysis of Outcomes and Complications.岩斜脑膜瘤的手术治疗：病例系列和结局及并发症的荟萃分析。
World Neurosurg. 2019 Sep;129:e700-e717. doi: 10.1016/j.wneu.2019.05.253. Epub 2019 Jun 7.
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